A Medium-Term Comparison of Quality of Life and Pain After Robotic or Laparoscopic Cholecystectomy.

INTRODUCTION: We sought to compare medium-term outcomes between robotic-assisted cholecystectomy (RC) and laparoscopic cholecystectomy (LC) using validated quality of life (QoL) and pain assessments. MATERIALS AND METHODS: Patients who underwent RC or LC between 2012 and 2017 at a single academic institution were examined. Cases converted to open were excluded. Patients were contacted by telephone in 2019 and completed two standardized surveys to rate their QoL and pain. RESULTS: Of those screened, 122 (35.8%) completed both surveys. Ninety three (76.2%) underwent RC and 29 (23.8%) underwent LC. The groups (RC versus LC) were similar based on mean age (47.9 versus 45.5 y, P = 0.48), gender (66.7% versus 72.4% female, P = 0.56), race (86.0% White/5.4% Black versus 72.4% White/13.8% Black, P = 0.2), insurance status (98.9% versus 100.0% insured, P = 0.58), median body mass index (31.8 versus 31.3, P = 0.43), and median Charlson Comorbidity Index (1 versus 0, P = 0.14). Fewer RC patients had a history of steroid use compared to LC (16.1% versus 34.5%, P = 0.03). No overall significant difference in QoL was demonstrated. LC group had higher severity of "tiring-exhausting pain" (P = 0.04), "electric-shock pain" (P = 0.003), and "shooting pain" (P = 0.05). The "overall intensity" of pain in the "gallbladder region" between the groups was similar at the time of follow-up (P = 0.31). CONCLUSIONS: QoL over 2-7 y following time of surgery is comparable for robotic-assisted versus conventional laparoscopic cholecystectomies. The laparoscopic approach may be associated with a higher severity of subset categories of pain, but overall pain between the two approaches is comparable.

Rectal Foreign Bodies: A 10-Year Review of the National Electronic Injury Surveillance System.

Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.

Ergonomics in hair restoration surgeons.

BACKGROUND: Musculoskeletal disorders (MSDs) are potential sources of morbidity in hair restoration surgeons (HRS). This is particularly true for those who perform follicular unit extraction (FUE). OBJECTIVE: To describe the nature, prevalence, and extent of ergonomic or work-related MSDs among HRS. METHODS & MATERIALS: A survey regarding MSDs was e-mailed to 100 HRS. RESULTS: Thirty-eight HRS completed the survey, the majority of which were male and between the ages of 50-69. Fifty percent of respondents reported musculoskeletal symptoms occurring during or after hair restoration procedures. Reports of pain during and after surgery were higher for FUE procedures than single strip excision procedures. Pain/fatigue/discomfort persisted for longer following FUE procedures compared to strip excision procedures. MSD symptoms also negatively impacted quality of life. Although the majority of respondents felt that ergonomics was important, only 30% use ergonomic support when performing FUE procedures. CONCLUSION: Hair restoration surgeons should be aware of MSD symptoms and particularly when performing FUE. Symptoms reported included pain, fatigue, and discomfort, sometimes lasting several hours following surgery. More attention needs to be paid to ergonomics during hair restoration procedures in order to improve the quality of life of surgeons and ultimately prevent the development of MSDs.